| NPI | 1912504978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704301134) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: CO AG01200132) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CO AG01200132) | |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2021-12-28 |